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Published on: July 21, 2023
Antimicrobial susceptibility patterns of Salmonella typhi and Salmonella paratyphi A in a tertiary care hospital
S Raza1, R Tamrakar, C P Bhatt
1Department of Microbiology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal. sahidktm@hotmail.com
Background:
Enteric fever is still an important public health problem in developing countries including Nepal. A changing antibiotic susceptibility pattern of Salmonella typhi and Salmonella paratyphi A and emergence of multi drug resistance has increased to a great concern. Aim of the study was to investigate the antibiotic susceptibility pattern of Salmonella typhi and Salmonella paratyphi A.
Methods:
Study was carried out at the department of microbiology in Kathmandu Medical College. Blood culture samples were collected from suspected enteric fever patient and tested microbiologically by standard procedure. Antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method and results were interpreted by National Committee for Clinical Laboratory (NCCLS) guideline.
Results:
Of total 78 (2.0%) Salmonella serotype isolated from 3,980 blood culture samples, in which 47 (60.3%) were S. typhi and 31 (39.7%) were S. paratyphi A. Isolates were from all age group median age being the 25 years. Among the tested antibiotics S. typhi was susceptible towards Ciprofloxacin (100%) followed by Gentamicin (97.9%), Ofloxacine (95.7%), Ceftriaxone (95.7%) and Chloramphenicol (93.6%). In case of S. paratyphi A most of the tested antibiotics showed high percentage of susceptibility and least susceptible antibiotic for S. paratyphi A was Ampicillin (25.8%). Three isolates of S. typhi showed multidrug resistance.
Conclusions:
A considerable variation was observed in the antimicrobial susceptibility pattern of S.typhi and S. paratyphi A. Hence antibiotic susceptibility test must be sought before instituting appropriate therapy to prevent from further emergence of drug resistance.
Insights
Enteric fever remains a public health concern in Nepal. This study investigated Salmonella typhi and Salmonella paratyphi A antibiotic resistance, finding variations and some multidrug-resistant strains, highlighting the need for susceptibility testing.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Enteric fever, caused by Salmonella typhi and Salmonella paratyphi A, is a significant public health issue in developing nations like Nepal.
- Emerging multidrug resistance in these pathogens presents a growing clinical challenge.
- Understanding current antibiotic susceptibility patterns is crucial for effective treatment.
Purpose of the Study:
- To investigate the antibiotic susceptibility patterns of Salmonella typhi and Salmonella paratyphi A isolates in Nepal.
- To identify trends in antimicrobial resistance relevant to enteric fever management.
Main Methods:
- Blood cultures from suspected enteric fever patients were analyzed.
- Microbiological testing and antibiotic susceptibility testing were performed using the Kirby-Bauer disc diffusion method.
- Results were interpreted according to National Committee for Clinical Laboratory (NCCLS) guidelines.
Main Results:
- Out of 3,980 blood cultures, 78 Salmonella serotypes were isolated (47 S. typhi, 31 S. paratyphi A).
- Salmonella typhi showed high susceptibility to Ciprofloxacin (100%), Gentamicin (97.9%), Ofloxacin (95.7%), Ceftriaxone (95.7%), and Chloramphenicol (93.6%).
- Salmonella paratyphi A exhibited high susceptibility to most tested antibiotics, with Ampicillin showing the lowest susceptibility (25.8%). Three S. typhi isolates displayed multidrug resistance.
Conclusions:
- Significant variations exist in the antimicrobial susceptibility profiles of S. typhi and S. paratyphi A.
- Routine antibiotic susceptibility testing is essential before initiating treatment to guide therapy and combat the rise of drug resistance.
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